Random thoughts from a few cantankerous American physicians. All contributors are board certified. Various specialties are represented here. I do not know where this will lead but hope it will at least be an enjoyable read. All of the names mentioned in this blog are pseudonyms, the ages have been changed, and in half the cases the gender as well. All photographs are published with patient consent or are digitally altered to preserve anonymity. Trust us, we're doctors.

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Tuesday, June 10, 2008

Looks like heading to the ER because of chapped lips won't fly any longer in the great state of Utah.

Utah's Medicaid program has received federal funding to help develop a program to divert Medicaid patients from the ER for non-emergent problems to primary care providers. This novel concept seems to make some sense, eh?

Created by the Deficit Reduction Act of 2005, about $50 million in grants will help Medicaid programs in 20 states fund local and rural initiatives to provide alternative health care settings for individuals with non-emergency medical needs. About friggin' time.

Hang in there 911 Doc and Shrodinger's Cat. The cavalry may be coming after all!

It's gotta help a little right? Anyway, I don't see how there could be a solution created that will instantly fix anything. It will probably take baby steps. Lots of baby steps. Here's to hoping the medical establishment can hang on.

I would go to a pay cash up front ER. Especially if I didn't have to wait 8 hours to make sure my Son isn't having an appendix problem...Maybe they could give you a frequent flyer card too. They could put it on my key chain with all the other little cards from CVS, Borders, Stop and shop, ETC, etc,,

nurse k dittos. fast tracking ER patients is difficult. in my last hospital we had a 'fast track' where we were supposed to turn and burn the 'quickies'. it was a dangerous place to work a shift because when the regular 'sick' beds got full they put folks in 'fast track' that 'weren't sick', nor was the fast track equipped to take care of sick patients. pretty soon they were putting cardiac monitors over there, and then they created a 'half fast track' for the 'iffies' and then it was the same as the main ER.

working the fast track was scary and the first thing i would check was which nurse was in triage. some nurses don't believe that anyone is sick and some believe everyone is sick and i admitted many a 'fast track' patient to the ICU.

then there's the other problem. for patients who are 'kinda sick', who fall out of triage parameters for fast track, they sit out in the waiting room and see tens of people go back to fast track while they wait for a 'regular bed'. they then complain and since our masters seem to only care about complaints the fast tracks seem to generate more complaints than they are worth.

You mean a psych who doesn't overrx? Someone who doesn't diagnose your neighbor's two year-old with BPD, schizo-affective, AND? Someone who knows a faker? That evaluator who kicks out the homeless guy looking for a place to do his laundry?You mean that every teen who is slightly depressed, slightly confused, isn't depressed? doesn't suffer from borderline personality disorder?

I'm just disappointed that Utah is the light at the end of the tunnel. The last guy that espoused that belief was hung in Illinois by an angry mob. Next thing you know we'll all be wearing magical undies too!